Environmental Factors Affecting Cognitive Function Among Community-dwelling Older Adults
Environmental Factors Affecting Cognitive Function Among Community-dwelling Older Adults
复制标题
影响社区老年人认知功能的环境因素
DOI：
10.1093/eurpub/ckab165.213
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发表时间：
2021
影响因子：
4.4
通讯作者：
S Kumakura
中科院分区：
文献类型：
--
作者：
A Motohiro;T Abe;K Okuyama;S Kumakura
虽然已经发现社区环境因素与认知能力下降有关，但很少有纵向研究关注它们对生活在农村地区的老年人的影响。本研究旨在探讨社区环境因素对农村老年人认知能力下降的影响。方法对2014 ~ 2018年两次调查中居住在日本云南市的503名年龄在50 ~ 60岁的老年人的数据进行分析。认知功能评估使用认知评估痴呆，iPad版本2。利用地理信息系统测量海拔、坡度、居住密度和与社区中心的接近程度。逻辑回归检验了每个社区环境因素（四分位数：Q1-Q4）对认知能力下降的影响。结果共57例（11.3%）参与者在随访中表现出认知功能下降。升高(优势比（OR）： 3.37, 95%置信区间（CI）： 1.11-10.20, Q3 vs. Q1；OR: 5.43, 95% CI: 1.89-15.56 （Q4 vs. Q1）和坡度(OR: 3.45, 95% CI: 1.46-8.11 （Q4 vs. Q1）与认知能力下降的可能性较高相关。居住密度和到社区中心的距离与认知能力下降无关。结论高原丘陵环境可能增加农村老年人认知能力下降的风险。山区居民往往难以到达各种生活中心。那些生活在山区的高地和丘陵地区的人，他们可以与他人互动的地方的可达性和可用性可能进一步受到限制。
BackgroundAlthough neighborhood environmental factors have been found to be associated with cognitive decline, few longitudinal studies have focused on their effect among older adults living in rural areas. This longitudinal study aimed to investigate the effect of neighborhood environmental factors on cognitive decline among rural older adults.MethodsThe data of 503 older adults aged > 60 years who were living in Unnan City in Japan and had participated in two surveys conducted between 2014 and 2018 were analyzed. Cognitive function was assessed using the Cognitive Assessment for Dementia, iPad version 2. Elevation, hilliness, residential density, and proximity to a community center were measured using geographic information system. Logistic regression examined the effect of each neighborhood environmental factor (in quartiles: Q1-Q4) on cognitive decline.ResultsA total of 57 (11.3%) participants demonstrated a decrease in cognitive function at follow up. Elevation (Odds ratio (OR): 3.37, 95% Confidence Interval (CI): 1.11-10.20 for Q3 vs. Q1; OR: 5.43, 95% CI: 1.89-15.56 for Q4 vs. Q1) and hilliness (OR: 3.45, 95% CI: 1.46-8.11 for Q4 vs. Q1) were associated with a higher likelihood of cognitive decline. Residential density and distance to a community center were not associated with cognitive decline.ConclusionsElevated and hilly environments may increase risk of cognitive decline among rural older adults.Key messagesResidents in mountainous regions tend to have limited accessibility to various living centers.Those who live in elevated and hilly areas within the mountainous regions may have further limited accessibility and availability of locations where they can interact with others.